NPI | 1053889907 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005764RX) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.005764RX) |
363AS0400X Physician Assistant, Surgical (Licence: OH 50.005764RX) | |
Enumeration Date | 2018-11-08 |
Last Update Date | 2019-11-12 |